The cystine-knot three-dimensional structure is found in many extracellular molecules and is conserved among divergent species.(ref 4) The cystine-knot structure is formed by the arrangement of six cysteines which, through their disulfide bonds, form a knot. A typical consensus motif for a cystine-knot structure is: X0-C1-X1-C2-X2-C3-X3-C4-X4-C5-X5-C6-X6 (amino acids of SEQ ID NO:2), wherein cysteines 2, 3, 5 and 6 form a ring that includes X2 and X3, by disulfide bonding of cysteines 2 and 5, and cysteines 3 and 6. The third disulfide bond between cysteines 1 and 4 penetrates the ring, thus forming a knot.(ref 2,3) FIG. 11 represents a schematic representation of a protein comprising a cystine-knot structure. This cystine-knot folding leads to the formation of three distinct domains, with two distorted beta-hairpin (beta-1 and beta-3) loops protruding from one side of the knot, and a single (beta-2) hairpin loop protruding from the other side of the knot. The beta-1 hairpin loop is formed by the stretch of amino acids between C1 and C2 and is designated “X1” in the above-mentioned consensus motif; the beta-2 (“X3”) and beta-3 (“X4”) hairpin loops are formed by the amino acid stretch between C3 and C4, and between C4 and C5, respectively.
Growth factors represent a large group of polypeptides that share the property of inducing cell multiplication both in vivo and in vitro. Although the level of sequence similarity between growth factors is low, they can be classified into subfamilies based on their structural and functional similarities. For instance, the following growth factor subfamilies all show the cystine-knot conformation described above: glycoprotein hormone-beta (GLHB) subfamily, the platelet-derived growth factor (PDGF) subfamily, the transforming growth factor beta (TGF-beta) subfamily, the nerve growth factor (NGF) subfamily, the glycoprotein hormone-alpha (GLHA) subfamily, CTCK subfamily, Noggin-like subfamily, Coagulin subfamily, Mucin-like subfamily, Mucin-like BMP-antagonist subfamily, Mucin-like hemolectin subfamily, Slit-like subfamily, and Jagged-like subfamily. However, the different sub-families have, for instance, different consensus lengths for X1, X2, X3, X4 and/or X5. Further, the different subfamilies have quite different functions and target organs. For instance, the GLHA and GLHB subfamilies are important for physiologic processes involved in reproduction, whereas members of the NGF subfamily exert their function mainly on nerve cells, and members of the PDGF subfamily mainly on endothelial cells.
Next to the cysteines involved in cystine-knot formation, other cysteines can be present in a cystine-knot protein, which are normally used to create further disulfide bonds within the cystine-knot, within the protruding domains, or between two proteins, for instance, during dimerization.
There has been extensive research on cystine-knot growth factors in health and disease, and therapeutic examples, for instance, are the use of vascular endothelial growth factor-specific antibodies (VEGF; a sub-subfamily of the PDGF subfamily) in the treatment of cancer, Bevacizumab (Avastin™), a monoclonal antibody developed by Genentech was approved in 2004 by the Food and Drug Administration (FDA) for the treatment of colorectal cancer, and the development of a follicle-stimulating hormone (FSH; a member of the GLHA/B subfamily) vaccine as a contraceptive for men. Major drawbacks of the therapeutic VEGF-specific monoclonal antibody Bevacizumab are the high production costs and relatively large amounts needed for treatment, sometimes low tumor penetration and its side effects. Furthermore, the antibody must be administered many times during a few months putting a high burden onto the patient.